Criticising Others Impairs Cognitive Ability

patient is angry on doctor because of medical error

It’s hard not to jump in and tell someone when they’re doing something wrong. But it appears there is a difference between explaining an error and just being down right rude. In a recent study1, researchers have found that putting people down actually impairs their cognitive abilities and in fact, makes their performance worse.

The researchers of University of Florida specifically targeted the neonatal emergency wards in hospitals to see how families of patients criticising medical staff impacted their performance. With thousands of patients dying in hospitals every year due to preventable errors, a team of American researchers at the University of Florida set out to review the effects of rude and disparaging comments on medical staff assisting in emergency situations.

The study, published in the journal Paediatrics1, found that criticising doctors and nurses who are caring for your child increases the risk of catastrophic outcomes and was worse than the effect of sleep deprivation on health professionals in terms of impacting their quality of care.

Now you might be tempted to think that having a disparaging comment thrown about here and there wouldn’t make that much difference to overall performance. And you wouldn’t be alone thinking that these medical staff might just need to harden up a bit. But that’s where you’d be wrong.

 “People may think that doctors should just ‘get over’ the insult and continue doing their job,” said lead author Professor Amir Erez.

But unfortunately that’s not how the brain works. No-one until now, realised quite the extent that being criticised had on the impact of an individual’s cognitive abilities.

“However, the study shows that even if doctors have the best intentions in mind, as they usually do, they cannot get over rudeness because it interferes with their cognitive functioning without an ability to control it.”

The study reviewed medical teams in 39 neonatal intensive care units, simulating acute care of term and preterm newborns. Two teams were randomly assigned to exposure to rude comments or neutral comments.

Those exposed to rude comments where doctors where exposed to such phrases as, “I knew we should have gone to a better hospital,” the medical team’s performance dropped.

In comparison, the neutral comment group, scored much higher. In direct contrast, those exposed to criticism scored lower on all areas, from time to diagnose, to diagnostic accuracy, to information sharing and treatment planning. Most concerning for the researchers was that the more criticised the team felt, the less they shared team processes. These processes such as information and workload sharing, helping each other and communicating are essential. In fact, these collaborative processes in medical treatment terms are recognised as being imperative for patient care and safety.

“Rudeness has robust, deleterious effects on the performance of medical teams,” the study concluded.

How can we translate the essence of this study into everyday life?

It is clear that criticising someone or being blatantly rude has deleterious effects on an individual’s performance. Which means we need to be aware of how we address and treat others that are our work colleagues, family or friends, specifically if what we want is an improvement in the situation we are calling to attention. If cognitive abilities are impaired through a barrage of negativity it may well behove us to be thoughtful about how we address errors or give feedback. If we want the best result, shouting at someone or ridiculing him or her clearly only reduces his or her ability to do the task. It may be that science has simply stumbled upon conclusive evidence of the old adage, treat others as you would like to be treated.



[1] Rudeness and Medical Team Performance Arieh Riskin, Amir Erez, Trevor A. Foulk, Kinneret S. Riskin-Geuz, Amitai Ziv, Rina Sela, Liat Pessach-Gelblum, Peter A. Bamberger Pediatrics Jan 2017

Comments are closed.